Dr Davis' Back & Wrist Pain Blog

Do Steroid Injections Work For Sciatica and Chronic Back Pain?

San Francisco Chronic Back Pain Center Comments:

Sciatica is one of the most common presentations at our San Francisco chronic back pain center. So, I thought it was appropriate to post on this article I came across on WebMD. The article is about a prominent neurology group that questions the use of steroid injections for the treatment of chronic back pain and sciatica. Here is an excerpt:

In reaching its conclusion, the American Academy of Neurology's Therapeutics and Technology Assessment Subcommittee reviewed four studies on epidural steroid injections for back pain with sciatica.

Based on the findings, epidural steroid shots are not recommended for long-term back pain relief, improving back function, or preventing back surgery, write neurology professor and subcommittee member Carmel Armon, MD, MHS, and colleagues.

My experience has been that steroid injections provide temporary relief at best. Anyway, draw your on conclusions.

If you or anyone you know is suffering with chronic back pain and would like to find out if you are a candidate for care at our San Francisco chronic back pain center, here are your options:

Call: 415-392-2225 and ask for a complimentary consultation or fill out our online information request form and someone will contact you by email.

Is Back Pain all In Your Head or Does Back Pain Mess Up Your Head?

San Francisco Chiropractor Comments on recent findings from chronic back pain study:

It is very frustrating for many patients with chronic back pain, for often times there appears to be no physical cause for their pain. The MRI is normal, the x-rays are normal, and the physical exam is normal. But, still, they are in pain, and they are not making it up. I have come across this situation many times at my San Francisco chronic back pain center and it is very frustrating for both patient and doctor. We both know that there is an effect for every cause, and a cause for every effect. Fortunately, because of my interest (and extensive studies) in the mind-body connection, I realized early on that there can be non-physical sources (mental) of physical pain. And we would address the problem accordingly with meditation, relaxation, and visualization techniques. Often times with great success. Other times with limited success or no success at all. This was disappointing to say the least. Especially if the patient was incapacitated as would often be the situation.

Anyway, it seems that researchers in Germany have found a connection between chronic back pain and microstructural changes in the pain-processing parts of the brain (see BBC News article). 

"They discovered the brains of patients with chronic back pain had a more complex and active microstructure compared with the healthy volunteer's brains."

This is very interesting and more research like this will be very helpful as far helping us to understand these frustrating cases of chronic back back that seem to be connected to mental vs. physical causes.

If you or anyone you know is suffering with chronic back pain and would like to find out if you are a candidate for care at our San Francisco chronic back pain center, here are your options:

Call: 415-392-2225 and ask for a complimentary consultation or fill out our online information request form and someone will contact you by email.

Will Back Surgery for Injured Spinal Discs be Replaced by Gel Injections?

San Francisco Disc Herniation Doctor comments on new Gel Injection therapy:

I just did my morning search for the latest back pain news stories and I came across this article from the University of Manchester. It seems they are studying a new gel for the treatment of spinal disc treatment. The gel is actually a liquid when injected, but turns into a gel once inside the body because the pH is lower (higher acidity) in the body.  The idea is that the herniated spinal discs or badly degenerated discs will actually become thicker and function better. They don't mention anything about the nature of the compound they are injecting. It sounds like it is chemical vs. natural. Anyway, it appears to still be in it's early stages. I know the biotech industry is working on many promising scientific advancements also. It will be very interesting in the years ahead. In the meantime however, we have have one spine to work with. My viewpoint is we do the best job we can to preserve what we have. If we do end up suffering with disc herniations , disc bulges, ruptured discs, etc., there are less invasive measures we can take before we consider surgery. One of these choices is non-surgical spinal decompression. We feature the DRX9000 at our San Francisco disc pain center. The DRX9000 was designed to treat herniated and degenerated discs. It's a good option to consider if you don't want surgery.

If you would like to find out if you are a candidate for non-surgical spinal decompression on the DRX9000, simply fill out this online form, or call 415-392-2225 and ask for a complimentary consultation. Chances are, you will be glad you did.

One in Four Americans Do NOT Exercise

The National Center for Health Statistics has found that a quarter of all Americans get virtually no exercise at all, putting them at higher risk of having a heart attack, diabetes and cancer. Levels of education, income and marital status seem to affect whether or not someone exercises. One in four adults with an advanced degree do high levels of exercise compared with only one in seven with less than a school diploma. Men are more likely to exercise than women. People from the Southern States of America do the least exercise. The poorer you are the less exercise you do. Adults with incomes below the poverty level are three times less likely to exercise than adults in the highest income group.

Dr Davis comments: As we all know, we need exercise. Life is motion. Without exercise our bodies cannot function as they were designed to. We are prone to the above mentioned diseases, as well as obesity and back pain. It is virtually impossible to express your health potential without exercise. Often times patients are unable to exercise because of health conditions such as back pain, but ironically, exercise may be just what they need. The right kind of exercise. I realize that often times those that are poor and uneducated do not have the available resources to even be aware of what they should be doing or could be doing. But, it amazes me how some of the people that do know, still choose the sedentary lifestyle. But, the good news is that is easy to get out of this funk and start exercising. If you are really deconditioned it makes sense to be checked out by a doctor or trained therapist that can start you off on a program base on your needs.

If you would like to meet with me to discuss your state of health and to see if I can help prescribe an exercise program for you that will work, please call 415-392-2225 and ask for a complimentary consultation with Dr. Davis.

Chinese Surgeons Show Promise with Transplanted Spinal Discs

I was just searching for the latest news on spinal health and came across this interesting article on disc transplants at Forbes Online. The transplants were done five years ago. Not very long ago, but no immune rejection, and only mild degenerative changes to new discs.

Hurt Your Back ? How Do You Know If it's Healing OK?

Health Update: It's a good question. We want to do the things that promote and speed healing, and not do the kinds of things that cause more harm or are destructive. A lot of us know that a little rest when we injure the back is ok, but staying in bed for a week might not be a good idea. Studies have shown that bed rest for more than 2 days causes even more pain. Since our goal is to move, then lying down doesn't seem like a worthwhile step towards that goal.

Some of us know that when the back flares up, ice is better than heat. Some of us still don't, and instead throw gasoline on the inflammation fire by having a soak in the hot tub.

These things are obvious on the list of do's and don'ts for the person with low back pain. But pain pills have a downside that a lot of us are not aware.

It seems like taking a pill for few days to help with pain is reasonable enough. Right? Maybe wrong.

For example, certain NSAIDs (e.g. ibuprofen) can make the scar formation in a muscle strain less effective. Instead of the scar being formed properly, it is in a more disorganized or scrambled fashion. If you have a poorer scar, the tissue will not be as strong and could lead to re-injury or a delay in your recovery. We don't think about it but just not taking pain pills early on would help for a lifetime. Ice can be an effective pain killer and doesn't come with medication-side effects.

Muscle relaxants are also prescribed for people with back pain. They are consumed by 49% of patients. The theory is that the muscle spasm should be relieved so that there can be less muscle pain. A study of patients who took muscle relaxants showed that these sufferers recovered more slowly. Unfortunately, the muscle spasm is there for good reason: to protect a delicate nerve.

Another thing that you have to consider besides poor scar formation and slowed healing, is the actual purpose of these medications. You have to also ask yourself why your body wants you to feel this pain. The body wants you to protect the area from movement. If you block the pain with medications, you may move too much, or too soon in the healing process, delaying your recovery.

A study that compared chiropractic adjustments to muscle relaxants in patients with low back pain had interesting results. There was also a sham adjustment group and a placebo medicine group. The authors concluded that chiropractic care had superior results.

The chiropractor can help guide you to when you can return to certain work or sports. By gradually integrating exercises into your daily routine as the function of the joints is improved, your injury can heal more naturally.

If you think you may be  candidate for care, please call 415-392-2225 and ask for a 15 minute complimentary telephone consultation.

What can be Done for Chronic Low Back Pain?

San Francisco Chiropractor comments on Chronic Low Back Pain:

Chronic low back pain effects millions of people. In fact, at any given time, up to 30% of the population is experiencing an episode of back pain. Up to 50% of the patients we treat at our San Francisco chiropractic center are for chronic low back pain. When pain last over 6 months it is considered chronic. In fact, most cases of back pain will actually resolve in short order (6-8 weeks) with traditional chiropractic or physical therapy. Some will just resolve on their own, at  least the symptoms will anyway. The danger with letting the back heal on it's own is that the spine may have lost it's normal alignment and is now what we call "subluxated" . If this happens it is possible that you actually feel better now, but are vulnerable to problems down the road. This is why professional athletes (and a lot of normal folks that understand) are typically checked for subluxations on an ongoing basis to make sure they do not manifest into bigger problems down the road such as disc herniations or chronic low back pain. In my 15 years of practice as a chiropractor I have treated hundreds if not thousands of cases of chronic low back pain. Most of them will respond to chiropractic care, but, some will not. Because of this I decided to incorporate nonsurgical spinal decompression into my practice. This technology was designed specifically for tough cases of chronic low back pain. The machines treat disc herniations, disc bulges, and spinal degeneration. We have helped many patients this way. Some have avoided surgery. Some have done the treatment after failed surgery. And some have just reduced or eliminated their chronic low back pain.  So, if you are a San Francisco Bay Area resident with chronic low back pain and would like to find out if nonsurgical spinal decompression is for you, simply fill out our chronic low back pain inquiry form or call 415-392-2225 and ask for a complimentary consultation. You will be glad you did.   

San Francisco Spinal Decompression Center Treats Herniated and Bulging Discs Without Drugs Or Surgery

Patients Find Relief, Physicians Find Promise in Nonsurgical Herniated Disc Treatment Technology

I have been using nonsurgical spinal decompression for over two years now at my San Francisco Financial District Back and Wrist Pain Center. The machine that I use is the DRX9000. I can treat disc herniations in the cervical or lumbar spine with my machines. As far as I know there are several DRX9000 machines in the SF Bay Area. At our clinic we incorporate nonsurgical decompression into a comprehensive care package that is different for everyone. There is a difference in expected outcomes between a 30 year old with a single disc herniation and a 60 year old with multiple disc herniations. There are many other factors as well, including overall health status, general condition of spine, previous surgeries, obesity, muscle spasms, short leg syndromes, etc. We incorporate spinal core reconditioning using swiss exercise balls and a state of the art machine called SpineForce to rehabilitate the core spinal muscles that support the spine. We also consider hands on chiropractic therapy or physical therapy modalities depending on the specific needs of the patient. In essence, the DRX9000 is used as a tool in conjunction with other therapies to achieve favorable outcomes vs. a stand alone magic wand. We also look closely at diet and nutrition and advise patients how to modify their diet so it works with the treatment, not against it. The DRX9000 allows us to treat many cases we would have previously referred out for medical treatment. Sure, we can't help everyone, nothing can. But, we are able to work with more patients. Patients with disc herniations, disc bulges, facet syndromes, and disc degeneration can be helped with the DRX9000. So, if you or anyone you know in the San Francisco Bay Area is suffering with disc related chronic back pain, you owe it to yourself to find out if you are a candidate for spinal decompression therapy. To find out, you can either fill out and submit this on-line form or call 415-392-2225 and ask for a complimentary disc pain evaluation.    

Cancer Burden Expected To Soar In Coming Years, Doctors Overwhelmed

San Francisco Back and Wrist Pain Doctor Comments:

There was an eye opening news article on the front page of yesterday's USA TODAY newspaper entitled Cancer Burden expected to soar . The article basically paints the very grim picture of the current state of health of our aging population. A recent study suggests that at the going rate, there will be a 55% increase in cancer patients (and survivors) by the year 2020. And, there will not be enough doctors to deal with the problem, because they are aging and retiring. They say that cancer is "a disease of the aging" as if it is a forgone conclusion that a certain percentage of people will be afflicted. I say that cancer is "a disease of excess", it is the result of lifestyle choices made by us. For example, lung cancer is the #1 killer, then prostate cancer in men, and breast cancer in women. Then, colon and rectal cancer, and pancreatic cancer (see chart). All of these deadly diseases have been linked directly to lifestyle choices such as smoking, drinking, drugs, stress, and most importantly diet. The article mentions how the other "ailments of old age" such as heart disease and diabetes will also see steep increases. These are also diseases that can be reduced or prevented with lifestyle modification. Some say our obesity rate is as high as 70% here in the US. As our appetite for meat and dairy products grows, so does our obesity rate, and so do the diseases of excess. In addition, it seems that the actual production of livestock is one of the primary contributors of greenhouse gases which cause global warming. Here is an excerpt from Dr. John McDougall M.D.s January 2007 newsletter:

The 2006 United Nations report, Livestock’s Long Shadow –Environmental Issues and Options, concludes “Livestock have a substantial impact on the world’s water, land and biodiversity resources and contribute significantly to climate change.” 

So, we have two of the our most serious problems, sickness, obesity, cancer and disease & global warming connected at the hip. What can we do about it ? Well, instead of spending billions of dollars on magic bullet drugs that will never work, we should spend more to really bring these issues into the main stream. Sure, every once in a while an article pops up like this one today (Americans need to eat more fruits and vegetables), but it's not enough. Dr. John McDougall, M.D., one of the worlds foremost authorities on plant based nutrition says that people want to read and listen to stuff that supports their bad habits, not vise versa. It's human nature. This is why the fad diets are always so popular, because they allow you to have your cake and eat it too. It's just so obvious, but nobody wants to talk about it. Even the so called green charities and environmental groups that are concerned with destruction of rain forests and biodiversity rarely acknowledge (publicly) that deforestation is primarily done for livestock production. I don't get. Actually, I do get it. It's all about money. The meat and dairy industries are very very powerful and so are the pharmaceutical companies. So, hopefully at some point the connection between planetary health and human health will hit the mainstream media before it's too late.

Are Golfers More Prone to Disc Herniations Than Non-Golfers ?

San Francisco Chronic Back Pain and Disc Herniation Doctor Comments:

We treat a lot of golfers with disc herniations at our San Francisco Financial District Disc Pain Center. The Executive lifestyle and golf go hand and hand,and the Bay Area has great weather, so it is pretty much a year round sport. In addition, many Baby Boomer's are retiring, so they are spending even more time out on the golf course. Some of the problems that golfers present with are things like back sprains, sciatica, disc bulges, disc herniations, and even neck, shoulder, wrist and hand pain. I do not golf that much, but it seems like every time I do my back gets a little sore, my hands too. This only makes sense because there is quite a bit of spinal rotation that goes into a golf swing, then at the point of impact (when you strike the ball, or miss it) there is a pretty good force that is absorbed by the body, especially if you do not have good form. If you have any pre-existing problems such as disc degeneration or shoulder problems, you are especially vulnerable to golf injuries. Anyway, I found a pretty good article that covers all the bases as far as how to prevent golf injuries from happening and what to do about them if they occur. The article was written by two medical doctors, so the recommendations are from their perspective. My personal opinion is that traditional chiropractic should probably be your first choice. If medical attention is necessary we can refer you to the appropriate doctor. Sometimes x-rays or MRI is needed to rule out disc herniation. If disc herniations are present and do not respond to conservative care then non-surgical spinal decompression is often times considered. If you or someone you know has suffered a golf injury, it is best to have it looked at right away before you play any more golf. Playing hurt can make the problem worse. For a complimentary consultation please call 415-392-2225.